Chinese General Practice ›› 2023, Vol. 26 ›› Issue (34): 4296-4301.DOI: 10.12114/j.issn.1007-9572.2023.0178
• Original Research • Previous Articles Next Articles
Received:
2023-03-29
Revised:
2023-07-07
Published:
2023-12-05
Online:
2023-07-21
Contact:
LI Dianjiang, PAN Enchun
通讯作者:
李殿江, 潘恩春
作者简介:
基金资助:
Add to citation manager EndNote|Ris|BibTeX
URL: https://www.chinagp.net/EN/10.12114/j.issn.1007-9572.2023.0178
项目 | 人数 | 存在临床惰性〔名(%)〕 | χ2值 | P值 |
---|---|---|---|---|
年龄(岁) | 0.301 | 0.584 | ||
<60 | 684 | 643(94.01) | ||
60~69 | 1 287 | 1 203(93.47) | ||
≥70 | 1 375 | 1 298(94.40) | ||
性别 | 2.526 | 0.112 | ||
男 | 1 201 | 1 139(94.84) | ||
女 | 2 145 | 2 005(93.47) | ||
教育水平 | 0.918 | 0.338 | ||
小学及以下 | 2 431 | 2 290(94.20) | ||
初中 | 627 | 586(93.46) | ||
高中/中专及以上 | 288 | 268(93.06) | ||
婚姻状况 | 0.907 | 0.341 | ||
已婚或同居 | 2 802 | 2 628(93.79) | ||
单身 | 544 | 516(94.85) | ||
家庭年收入(万元) | 0.201 | 0.654 | ||
<1 | 845 | 789(93.37) | ||
1~10 | 1 938 | 1 827(94.27) | ||
>10 | 563 | 528(93.78) | ||
当前吸烟 | 0.768 | 0.381 | ||
否 | 2 652 | 2 487(93.78) | ||
是 | 694 | 657(94.67) | ||
当前饮酒 | 2.304 | 0.129 | ||
否 | 2 841 | 2 662(93.70) | ||
是 | 505 | 482(95.45) | ||
控制饮食 | 9.684 | 0.002 | ||
是 | 2 623 | 2 447(93.29) | ||
否 | 723 | 697(96.40) | ||
体育锻炼情况a | 5.339 | 0.021 | ||
坚持锻炼 | 1 322 | 1 226(92.74) | ||
偶尔锻炼 | 806 | 762(94.54) | ||
从不锻炼 | 1 218 | 1 156(94.91) | ||
血糖监测周期(周) | 32.944 | <0.001 | ||
≤1 | 593 | 527(88.87) | ||
>1 | 2 753 | 2 617(95.06) | ||
BMI(kg/m2) | 1.398 | 0.237 | ||
<24.0 | 1 199 | 1 134(94.58) | ||
24.0~27.9 | 1 461 | 1 370(93.77) | ||
≥28.0 | 686 | 640(93.29) | ||
糖尿病并发症 | 16.119 | <0.001 | ||
无 | 2 922 | 2 764(94.59) | ||
有 | 424 | 380(89.62) | ||
高血压(史) | 0.732 | 0.392 | ||
无 | 864 | 817(94.56) | ||
有 | 2 482 | 2 327(93.76) | ||
血脂异常(史) | 7.808 | 0.005 | ||
无 | 1 391 | 1 326(95.33) | ||
有 | 1 955 | 1 818(92.99) | ||
冠心病史 | 12.576 | <0.001 | ||
无 | 2 907 | 2 748(94.53) | ||
有 | 439 | 396(90.21) | ||
脑卒中史 | 10.277 | 0.001 | ||
无 | 2 548 | 2 413(94.70) | ||
有 | 798 | 731(91.60) | ||
肿瘤病史 | 4.328 | 0.038 | ||
无 | 3 233 | 3 043(94.12) | ||
有 | 113 | 101(89.38) | ||
HbA1c(%) | 3.823 | 0.051 | ||
7.0~7.9 | 1 109 | 1 051(94.77) | ||
8.0~8.9 | 818 | 774(94.62) | ||
≥9.0 | 1 419 | 1 319(92.95) |
Table 1 General data of T2DM patients in community
项目 | 人数 | 存在临床惰性〔名(%)〕 | χ2值 | P值 |
---|---|---|---|---|
年龄(岁) | 0.301 | 0.584 | ||
<60 | 684 | 643(94.01) | ||
60~69 | 1 287 | 1 203(93.47) | ||
≥70 | 1 375 | 1 298(94.40) | ||
性别 | 2.526 | 0.112 | ||
男 | 1 201 | 1 139(94.84) | ||
女 | 2 145 | 2 005(93.47) | ||
教育水平 | 0.918 | 0.338 | ||
小学及以下 | 2 431 | 2 290(94.20) | ||
初中 | 627 | 586(93.46) | ||
高中/中专及以上 | 288 | 268(93.06) | ||
婚姻状况 | 0.907 | 0.341 | ||
已婚或同居 | 2 802 | 2 628(93.79) | ||
单身 | 544 | 516(94.85) | ||
家庭年收入(万元) | 0.201 | 0.654 | ||
<1 | 845 | 789(93.37) | ||
1~10 | 1 938 | 1 827(94.27) | ||
>10 | 563 | 528(93.78) | ||
当前吸烟 | 0.768 | 0.381 | ||
否 | 2 652 | 2 487(93.78) | ||
是 | 694 | 657(94.67) | ||
当前饮酒 | 2.304 | 0.129 | ||
否 | 2 841 | 2 662(93.70) | ||
是 | 505 | 482(95.45) | ||
控制饮食 | 9.684 | 0.002 | ||
是 | 2 623 | 2 447(93.29) | ||
否 | 723 | 697(96.40) | ||
体育锻炼情况a | 5.339 | 0.021 | ||
坚持锻炼 | 1 322 | 1 226(92.74) | ||
偶尔锻炼 | 806 | 762(94.54) | ||
从不锻炼 | 1 218 | 1 156(94.91) | ||
血糖监测周期(周) | 32.944 | <0.001 | ||
≤1 | 593 | 527(88.87) | ||
>1 | 2 753 | 2 617(95.06) | ||
BMI(kg/m2) | 1.398 | 0.237 | ||
<24.0 | 1 199 | 1 134(94.58) | ||
24.0~27.9 | 1 461 | 1 370(93.77) | ||
≥28.0 | 686 | 640(93.29) | ||
糖尿病并发症 | 16.119 | <0.001 | ||
无 | 2 922 | 2 764(94.59) | ||
有 | 424 | 380(89.62) | ||
高血压(史) | 0.732 | 0.392 | ||
无 | 864 | 817(94.56) | ||
有 | 2 482 | 2 327(93.76) | ||
血脂异常(史) | 7.808 | 0.005 | ||
无 | 1 391 | 1 326(95.33) | ||
有 | 1 955 | 1 818(92.99) | ||
冠心病史 | 12.576 | <0.001 | ||
无 | 2 907 | 2 748(94.53) | ||
有 | 439 | 396(90.21) | ||
脑卒中史 | 10.277 | 0.001 | ||
无 | 2 548 | 2 413(94.70) | ||
有 | 798 | 731(91.60) | ||
肿瘤病史 | 4.328 | 0.038 | ||
无 | 3 233 | 3 043(94.12) | ||
有 | 113 | 101(89.38) | ||
HbA1c(%) | 3.823 | 0.051 | ||
7.0~7.9 | 1 109 | 1 051(94.77) | ||
8.0~8.9 | 818 | 774(94.62) | ||
≥9.0 | 1 419 | 1 319(92.95) |
自变量 | b | SE | Wald χ2值 | P值 | OR(95%CI) |
---|---|---|---|---|---|
控制饮食(以否为参照) | |||||
是 | -0.537 | 0.217 | 6.136 | 0.013 | 0.585(0.382,0.894) |
血糖监测周期(以>1周为参照) | |||||
≤1周 | -0.754 | 0.160 | 22.170 | <0.001 | 0.470(0.344,0.644) |
糖尿病并发症(以无为参照) | |||||
有 | -0.502 | 0.183 | 7.478 | 0.006 | 0.606(0.423,0.868) |
血脂异常(史)(以无为参照) | |||||
有 | -0.322 | 0.158 | 4.159 | 0.041 | 0.725(0.532,0.988) |
冠心病史(以无为参照) | |||||
有 | -0.417 | 0.186 | 5.037 | 0.025 | 0.659(0.458,0.949) |
脑卒中史(以无为参照) | |||||
有 | -0.359 | 0.160 | 5.063 | 0.024 | 0.699(0.511,0.955) |
Table 2 Stepwise multiple Logistic regression analysis of the detection rate of clinical inertia in T2DM patients in community
自变量 | b | SE | Wald χ2值 | P值 | OR(95%CI) |
---|---|---|---|---|---|
控制饮食(以否为参照) | |||||
是 | -0.537 | 0.217 | 6.136 | 0.013 | 0.585(0.382,0.894) |
血糖监测周期(以>1周为参照) | |||||
≤1周 | -0.754 | 0.160 | 22.170 | <0.001 | 0.470(0.344,0.644) |
糖尿病并发症(以无为参照) | |||||
有 | -0.502 | 0.183 | 7.478 | 0.006 | 0.606(0.423,0.868) |
血脂异常(史)(以无为参照) | |||||
有 | -0.322 | 0.158 | 4.159 | 0.041 | 0.725(0.532,0.988) |
冠心病史(以无为参照) | |||||
有 | -0.417 | 0.186 | 5.037 | 0.025 | 0.659(0.458,0.949) |
脑卒中史(以无为参照) | |||||
有 | -0.359 | 0.160 | 5.063 | 0.024 | 0.699(0.511,0.955) |
方案 | 人数〔名(%)〕 | 排序 |
---|---|---|
在原有口服降糖药剂量的基础上,增加了用药剂量 | 81(40.10) | 1 |
在原有口服降糖药种类的基础上,增加了用药种类 | 36(17.82) | 3 |
停止使用原有口服降糖药,将其更换为新的降糖药 | 21(10.40) | 4 |
停止使用原有口服降糖药,治疗方式由口服降糖药变为注射胰岛素 | 19(9.41) | 5 |
在原有胰岛注射次数或剂量的基础上,增加了胰岛素注射次数或剂量 | 39(19.31) | 2 |
在接受原有胰岛素治疗的基础上,同时口服降糖药 | 13(6.44) | 6 |
Table 3 Intensification in antidiabetic treatment for 202 T2DM patients with inadequate HbA1c control within the past 3 months in community
方案 | 人数〔名(%)〕 | 排序 |
---|---|---|
在原有口服降糖药剂量的基础上,增加了用药剂量 | 81(40.10) | 1 |
在原有口服降糖药种类的基础上,增加了用药种类 | 36(17.82) | 3 |
停止使用原有口服降糖药,将其更换为新的降糖药 | 21(10.40) | 4 |
停止使用原有口服降糖药,治疗方式由口服降糖药变为注射胰岛素 | 19(9.41) | 5 |
在原有胰岛注射次数或剂量的基础上,增加了胰岛素注射次数或剂量 | 39(19.31) | 2 |
在接受原有胰岛素治疗的基础上,同时口服降糖药 | 13(6.44) | 6 |
[1] |
|
[2] |
|
[3] |
|
[4] |
李殿江,王琴,潘恩春,等. 糖尿病临床惰性问题及其系统化预防方法[J]. 中国全科医学,2020,23(34):4377-4380. DOI:10.12114/j.issn.1007-9572.2020.00.051.
|
[5] |
李翔,许樟荣,朱大龙,等. 2型糖尿病患者治疗过程中的临床惰性及其影响因素:一项多中心观察性研究结果[J]. 中华糖尿病杂志,2020,12(2):81-85. DOI:10.3760/cma.j.issn.1674-5809.2020.02.005.
|
[6] |
|
[7] |
|
[8] |
|
[9] |
|
[10] |
中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)[J]. 中华糖尿病杂志,2021,13(4):315-409. DOI:10.3760/cma.j.cn115791-20210221-00095.
|
[11] |
孙中明,潘恩春,缪丹丹,等. 淮安市2型糖尿病患者血糖控制情况与糖尿病家族史的关系[J]. 中华内分泌代谢杂志,2017,33(7):578-580. DOI:10.3760/cma.j.issn.1000-6699.2017.07.008.
|
[12] |
苏健,覃玉,沈冲,等. 江苏省社区管理2型糖尿病患者综合控制情况分析[J]. 中华内分泌代谢杂志,2018,34(2):112-120. DOI:10.3760/cma.j.issn.1000-6699.2018.02.005.
|
[13] |
中华医学会糖尿病学分会,国家基层糖尿病防治管理办公室. 国家基层糖尿病防治管理指南(2022)[J]. 中华内科杂志,2022,61(3):249-262. DOI:10.3760/cma.j.cn112138-20220120-000063.
|
[14] |
中国肥胖问题工作组. 中国成人超重和肥胖症预防与控制指南(节录)[J]. 营养学报,2004,27(1):1-4.
|
[15] |
中国高血压防治指南修订委员会,高血压联盟(中国),中华医学会心血管病学分会,等. 中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志,2019,24(1):24-56. DOI:10.3969/j.issn.1007-5410.2019.01.002.
|
[16] |
中国成人血脂异常防治指南修订联合委员会. 中国成人血脂异常防治指南(2016年修订版)[J]. 中华心血管病杂志,2016,44(10):833-853. DOI:10.3760/cma.j.issn.0253-3758.2016.10.005.
|
[17] |
中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)[J]. 中华糖尿病杂志,2021,13(4):315-409. DOI:10.3760/cma.j.cn115791-20210221-00095.
|
[18] |
姚红萍,陆叶,郑茹,等. 2型糖尿病患者用药特征及服药依从性的相关性研究[J]. 安徽医学,2022,43(9):1030-1034. DOI:10.3969/j.issn.1000-0399.2022.09.009.
|
[19] |
|
[20] |
刘美岑,刘远立,尤莉莉. 国家基本公共卫生服务利用对2型糖尿病患者规律服药行为及血糖控制的影响研究[J]. 公共卫生与预防医学,2022,33(4):1-7. DOI:10.3969/j.issn.1006-2483.2022.04.001.
|
[21] |
|
[1] | BAI Haiwei, MI Xiaokun, LIU Qingrui, ZHU Lin, WANG Yingnan, LIU Junyan, HAN Ying. Predictive Value of Serum Uric Acid in Perioperative Acute Ischemic Stroke in Patients with Non-small Cell Lung Cancer [J]. Chinese General Practice, 2023, 26(36): 4545-4551. |
[2] | WANG Shiyue, DONG Chen, CHANG Chudi, NAN Yuemin. Opportunities and Challenges of Surveillance for Liver Cancer in Primary Care Institutions in China [J]. Chinese General Practice, 2023, 26(36): 4498-4504. |
[3] | LU Lixia, WANG Rongqi. Advances in Liver Cancer Screening and Health Surveillance Management in Primary Care Institutions [J]. Chinese General Practice, 2023, 26(36): 4505-4509. |
[4] | XIE Xuemei, GAO Jing, BAI Dingxi, LU Xianying, HE Jiali, LI Yue. Current Status of Polypharmacy in the Elderly and Its Influencing Factors: a Meta-analysis [J]. Chinese General Practice, 2023, 26(35): 4394-4403. |
[5] | CHU Xiaojing, LI Jun, FU Yanqin, LIU Danqing, LIU Aiping, ZHANG Yuanyuan. Effect of Human Body Composition and Serum Biochemical Indicators on the Accuracy of Flash Glucose Monitoring System [J]. Chinese General Practice, 2023, 26(35): 4433-4438. |
[6] | HAO Aihua, ZENG Weilin, LI Guanhai, XIA Yinghua, CHEN Liang. Current Situation of the Construction of Family Doctor Team: an Investigation Based on the Perspective of General Practitioners [J]. Chinese General Practice, 2023, 26(34): 4261-4268. |
[7] | HUANG Jinling, ZENG Zhirong. The Logic and Trend of Urban Community Health Service Policies in China [J]. Chinese General Practice, 2023, 26(34): 4239-4245. |
[8] | YANG Hui, HU Ruwei, LIU Ruqing, LU Junfeng, WU Jinglan. Relationship between Community Health Service Experience and Glycemic Control Outcomes in Patients with Diabetes Mellitus [J]. Chinese General Practice, 2023, 26(34): 4290-4295. |
[9] | WANG Yue, CHEN Qing, LIU Lurong. Detection Rate of Depression and Its Influencing Factors in Chinese Elderly: a Meta-analysis [J]. Chinese General Practice, 2023, 26(34): 4329-4335. |
[10] | XU Jian, DAI Fangfang, PAN Wenlei, HUANG Qian, LU Ping, WANG Jianfeng, JIA Huan, YANG Yuqi, HUANG Jiaoling. Visual Analysis of Hotspots and Cutting-edge Trends of Community TCM Service Research in China in the Context of Healthy China [J]. Chinese General Practice, 2023, 26(34): 4343-4350. |
[11] | YAO Yuzhong, MA Xiaojun, SONG Huan, ZHONG Yu. The Management Effect of Diabetes "1358 model" on Community Diabetes Patients Based on "Precision Management Combining General Care and Specialty Care" [J]. Chinese General Practice, 2023, 26(34): 4308-4314. |
[12] | QIN Fengyin, ZHANG Qishan, LAI Jinjia, HUANG Yimin, HAN Guoyin, SUN Xinglan, WANG Fen, TAN Yibing. Current Status and Influencing Factors of the Intention to Screen for High-risk Stroke among Community Residents in Guangdong [J]. Chinese General Practice, 2023, 26(34): 4283-4289. |
[13] | ZHOU Yuyu, GAO Chuan, CUI Puan, WANG Yaping, HE Zhong. Influencing Factors of Shared Decision Making between Doctors and Patients in Menopausal Hormone Therapy in Patients with Menopausal Syndrome [J]. Chinese General Practice, 2023, 26(33): 4181-4186. |
[14] | WANG Lina, GAO Pengfei, CAO Fan, GE Ying, YAN Wei, HE Daikun. Analysis of the Prevalence and Influencing Factors of Non-alcoholic Fatty Liver Disease in Different Gender Groups [J]. Chinese General Practice, 2023, 26(33): 4143-4151. |
[15] | ZHANG Jin, DING Zhiguo, QI Shuo, LI Ying, LI Weiqiang, ZHANG Yuanyuan, ZHOU Tong. Relationship between Serum Thyroid Hormone Levels and Prognosis during Hospitalization in Heart Failure Patients [J]. Chinese General Practice, 2023, 26(33): 4125-4129. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||